[Relevance of cultures for the antibiotic treatment in acute perforated appendicitis].

The case records of 71 patients (31 women and 40 men aged 5-76 years, median age 18) who were registered under the diagnosis of perforated acute appendicitis at the Department of Surgery, Frederikssund Hospital between 1 January 1983 to 31 December 1988 have been reviewed in order to examine the relevance of culturing peritoneal swabs for the antibiotic treatment given. Four antibiotic regimens were used. In 65% of the cases, the cultured bacteria were completely sensitive to gentamycin and metronidazole (82% when cultures where there was no growth are included), the corresponding figure for the treatment given was 48% (65%). Thirty-one percent developed postoperative infections, 20% in the form of abscesses. In four percent of the cases where bacterial resistance to the given antibiotic treatment was found did this result have a consequence in relation to further treatment. The result of culture was on average available 2.1 days after antibiotic treatment had been terminated. The cultures could have greater relevance if 1) the results were communicated to the ward within one to two days 2) bacterial type and pattern of antibiotic sensitivity were registered in such a manner that the effectivity of the standard antibiotic regime could be controlled and 3) if demonstration of possible exogenous contamination were used as a parameter in the department's quality control.